Living Well With Chronic Pain
For most of us, the occasional ache or niggle is a short-lived experience; we strain our back picking up something heavy or sleep oddly, waking up with a stiff neck. For someone living with a chronic pain condition, however, it can be a long, unrelenting struggle, defining a totally different experience of pain.
What is pain?
Pain is an unpleasant experience shared by all human beings. The highlight here is on the concept of experience - the way your brain makes sense of what is going on inside and outside of yourself and how you then perceive this. We all experience what our brain decides for us to see/feel, and this also applies to pain.
But what is the use of pain?
Well, pain is one of the most sophisticated survival mechanisms. Its role is to protect us, making us avoid damage and seek things that are good and healthy for us. As most people would agree, the last thing we want is to be in pain!
How do we feel pain
Sensory nerves are like wires that carry messages from the body to the brain - say you strain your back muscles lifting a weight, your nerves will send this information upwards. The brain is like the control centre deciding if anything needs to be done based on the signals it receives. We can think of this like an alarm system that will go off if the signals are important enough for the brain to turn the alarm bells on, and continues until the ‘danger’ has passed and the alarm stops.
Interestingly, the alarm is much louder if we focus on it, or we are feeling depressed, stressed or particularly threatened by this pain. Being given a diagnosis of ‘arthritis’ can do this as it conjures images of painfully swollen joints even if yours aren't that bad. On the contrary, the alarm will be quieter if we are relaxed and don’t feel threatened by it.
But what happens when the brain’s interpretation of the signals isn’t that accurate?
Chronic pain
Usually, as the signals carried by your nerves diminish and the brain understands that ‘danger is over’ and, once again, when we are comfortable and relaxed, pain subsides. However, there are times in which this just does not happen. This is what happens with chronic pain syndromes such as fibromyalgia, where the person experiences widespread muscle pain, stiffness and extreme fatigue, without there being any specific damage or reason for it. In other words, the brain thinks there is ‘danger’ and turns on the alarm system when it should not.
But why does it happen?
Science still does not clearly understand what causes pain to become chronic. What we know is that people with chronic pain will often show chemical imbalances in the spinal cord and high activity of certain brain areas, usually those involved in producing pain and unpleasant emotions: this is what we call central sensitisation. Additionally, chronic pain sufferers tend to show high emotional investment in the pain and attachment to beliefs that may not be helpful. After all, as we said pain is an experience and psychological and social factors play a huge role in chronic pain, but not for this is the experience of pain any less real.
What can you do?
Physical activity: While physical activity may be the one most important remedy for chronic pain, with all its physical and mental benefits, for someone with chronic pain it can be tricky to get the intensity right, as overdoing it can provoke extreme fatigue and painful flare-ups in the joint and muscles. Research has shown that light to moderate aerobic exercise two to three times per week can reduce pain and fatigue, and improve mood in patients with fibromyalgia. Mind-body exercises such as yoga and tai-chi are really helpful at reestablishing ‘good communication’ between the brain and the body. Also, water exercises such as aqua aerobics can take some pressure off on the joints and help manage the symptoms of fibromyalgia.
Pacing: when approaching physical activity, pacing is crucial. It is common to overdo things on the good days, when pain is minimal, only to then be bed-bound in pain for the next couple days, losing our fitness and motivation to move. Pacing essentially means taking a break before you actually feel you need it, whilst working toward your activity goals even on the days in which you do not feel like doing it.
Nutrition & hydration: Often those who suffer from chronic pain can show signs of systemic inflammation, and our diets play a role in this. Research by Harvard suggests that a balanced and varied diet which includes anti-inflammatory and antioxidant-rich foods such as whole grains, dark green leafy vegetables, nuts and berries. Omega-3 fatty acids found in foods such as oily fish (salmon, sardines and mackerel) and olive oil can also support the immune system and reduce inflammation.
Breathing: A simple breathing exercise called diaphragmatic breathing or ‘belly breathing’ can be helpful in reducing muscle tension and lowering stress levels, it can also be a great mindfulness tool to distract you from your pain. Research has shown that using your diaphragm effectively stimulates the vagus nerve which induces a relaxation response in your nervous system, slowing down heart rate, reducing blood pressure and stress. It also reduces muscle tension around your shoulders and upper back which is where a lot of us hold stress unconsciously.
Quick breathing activity:
- Lie on your back, with knees up or a pillow underneath your knees.
- Place one hand on your chest and one on your stomach just below your rib cage, take a breath deep into your lungs until you feel your belly rise, gently exhale and repeat a few more times, you should feel your stomach hand rise and your chest hand stay relatively still.
- Create a routine where you do it every morning before getting up and every night before sleep and it will gradually become a habit.
Quality of sleep: Living with chronic pain can be tiring and disturbed sleep is not uncommon so you may find you need more sleep than the recommended eight hours. Establishing good sleep habits such as reducing blue light exposure before bed (phones, TVs etc), sticking to a routine, avoiding stimulants such as caffeine, nicotine and alcohol before bed, and if you need a nap during the day then keep it to 20-40 minutes so you don’t struggle to fall asleep later that night. Also ensure you have a dark bedroom by using blackout blinds or an eye mask as complete darkness is optimal for melatonin production which will help regulate your sleep cycle. Research has also shown it to play a role in reducing pain perception.
How can osteopathy help?
Osteopathy can help treat the symptoms of chronic pain through gentle techniques to relax tight and sore muscles, improve circulation and reduce inflammation. An Osteopath will help you better understand your condition and give advice on exercise and lifestyle so you can manage your pain from a more empowered and knowledgeable position.
Osteopaths at Core Clapton are highly trained in managing and treating a variety of conditions. For more info on how osteopathy could help with your pain call 0300 561 0161 or email us at info@coreclapton.org
